11 Who should perform the FNA?The person who is going to read it! (pathologist adequately trained)Gleans information from gross findings and feel of the needleLess unsatisfactory results (multiple passes as needed)Less interpretative errorsHighest sensitivity and specificity

62 Lobular carcinoma Low to moderate cellularitySmall chains or groups of cells, single cellsUniform population, small to medium sized cellsMild atypia, inconspicuous nucleoliOccasional signet ring cellsSource of false negativeFeel of the needle in the mass while doing FNA is most helpful

95 ConclusionsCompared to CNB, FNA may not provide all the necessary information in modern management of some cases of breast ca.Small lesions to determine management of the axillaSome larger lesions where preoperative chemotherapy is a consideration.

96 ConclusionsCNB has replaced FNA in non palpable mammographically detected lesionsFNA is highly reliable in palpable masses particularly in the hands of properly trained aspirators and interpretersFNA needs to be incorporated in the TT

99 Advantages of FNADefinitive dx in inoperable ca, chest wall recurrence and LN metastasesUseful in pregnant patientsDiagnostic and therapeutic in benign cystsHelpful in triaging patients for surgeryDecreases time in OR (eliminates need for FS)